Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Optum Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $467.74 / $1,047.13	Facility		$398.11	$467.74	$1,047.13
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $467.74 / $1,047.13	Facility		$398.11	$467.74	$1,047.13